Actor Models for Policy Analysis

Hermans, Leon M.; Cunningham, Scott

doi:10.1007/978-1-4614-4602-6_8

Cited by 15 publications

(11 citation statements)

References 47 publications

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“…Policy development is a process, which happens over time and requires both intra- and inter-organizational coordination [ 58 ]. The role of actors (players), their underlying interests and the level of their commitments toward the desired policy or specific issue, and also understanding their perceptions and values is another important factor in developing and implementing a policy [ 11 , 59 , 60 ]. Government, as one of influential actors, did not take its full role in implementing hospital autonomy policy in Iran.…”

Section: Discussionmentioning

confidence: 99%

Fail to prepare and you can prepare to fail: the experience of financing path changes in teaching hospitals in Iran

Doshmangir

Rashidian

Jafari

et al. 2016

BMC Health Serv Res

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BackgroundIn 1995, teaching and public hospitals that are affiliated with the ministry of health and medical education (MOHME) in Iran were granted financial self-sufficiency to practice contract-based relations with insurance organizations. The so-called “hospital autonomy” policy involved giving authority to the insurance organizations to purchase health services. The policy aimed at improving hospitals’ performance, hoping to reduce government’s costs. However, the policy was never implemented as intended. This was because most participating hospitals gave up to implement autonomous financing and took other financing pathways. This paper analyses the reasons for the gap between the intended policy and its execution. The lessons learned from this analysis can inform, we envisage, the implementation of similar initiatives in other settings.MethodsWe conducted semi-structured interviews with 28 national and 13 regional health policy experts. We also gathered a comprehensive and purposeful set of related documents and analyzed their content. The qualitative data were analyzed by thematic inductive-deductive approach.ResultsWe found a number of prerequisites and requirements that were not prepared prior to the implementing hospital autonomy policy and categorized them into policy content (sources of funds for the policy), implementation context (organization of insurance organizations, medical tariffs, hospitals’ organization, feasibility of policy implementation, actors and stakeholders’ support), and implementation approach (implementation method, blanket approach to the implementation and timing of implementation). These characteristics resulted in unsuitable platform for policy implementation and eventually led to policy failure.ConclusionsAutonomy of teaching hospitals and their exclusive financing through insurance organizations did not achieve the desired goals of purchaser-provider split in Iran. Unless contextual preparations are in place, hospital autonomy will not succeed and problematic financial relations between service providers and patients in autonomous hospitals may not be ceased as a result.

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Section: Discussionmentioning

confidence: 99%

Fail to prepare and you can prepare to fail: the experience of financing path changes in teaching hospitals in Iran

Doshmangir

Rashidian

Jafari

et al. 2016

BMC Health Serv Res

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“…Expert consultation is also used, for instance, to better understand the legal and institutional frameworks operating in the region. This process, in general, of establishing the full decision-making context is known as describing the arena of the problem (Hermans and Cunningham 2013). Project goals are also established in this step.…”

Section: The Game-structuring Methodsmentioning

confidence: 99%

A game-structuring approach applied to estuary management in South Africa

Slinger

Cunningham

Hermans

et al. 2014

EURO Journal on Decision Processes

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A game-structuring method is applied in a contested, real-world setting of estuary management in South Africa. The key activities undertaken in applying the six step game-structuring method are described and artefacts developed in the process are provided. Participants were readily able to identify strategic outcomes and payoffs in the case. Conversely, identifying actions in a well-timed sequence proved difficult. Choices to focus the discussion of actions on real-world biophysical and infrastructural interventions proved necessary for successful method application. The implications for method design and the challenges of using the game-structuring method as a mediating intervention form the subject of reflection.

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“…This includes then, for example, informing and empowering stakeholders (Hermans and Cunningham, 2013). Diagnosis of interests and actors may also serve as a basis or justification for a program of action that will achieve that interest.…”

Section: Interestmentioning

confidence: 99%

Public Policy: Ethics

Klimczuk

2015

International Encyclopedia of the Social &Amp; Behavioral Sciences

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There are many ethical dimensions of public policy. Public policy as actions to solve the collective problems includes directly or indirectly making ethical judgments. Public policy takes into account reconciliation of conflicting interests of individuals, groups, and organizations which is based on the values agreeing which influences on the objectives, principles, and styles of policy implementation. Ethical judgments about selecting more and less important as well as more positive problem solutions are present on all stages of policy cycle.

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Actor Models for Policy Analysis

Cited by 15 publications

References 47 publications

Fail to prepare and you can prepare to fail: the experience of financing path changes in teaching hospitals in Iran

Fail to prepare and you can prepare to fail: the experience of financing path changes in teaching hospitals in Iran

A game-structuring approach applied to estuary management in South Africa

Public Policy: Ethics

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